BY GRANT MERCER – Just over 50 years ago, Surgeon General Luther Terry issued a landmark report linking smoking to disease and death. At the time, smoking was commonplace and even considered fashionable.  Movies and advertisements, filled with images of stars like John Wayne, Clint Eastwood and Audrey Hepburn, made smoking seem an absolute necessity on the path to being cool. Even the president under which he served, John F. Kennedy, was a noted smoker. Terry’s report led to a Congressional mandate requiring warning labels on cigarette packaging and the banning of TV and radio ads.  At the time the report was issued, nearly 45% of American adults smoked while today around 17% smoke. Terry’s 1964 Surgeon General’s report was responsible for saving thousands of American lives.

Part educator and part fitness coach, the Office of the U.S. Surgeon General serves as the voice of authority for health care, guiding all Americans on ways to improve their well-being. Originally started in the 18th century as a means to safeguard seamen’s health, it was expanded seventy years later to include all Americans.

The Surgeon General’s office is one of the seven uniformed branches of the military. Reporting up through the Department of Health and Human Services, “America’s Doctor” is charged with protecting, promoting and advancing the health of our nation. Appointed by the President and ratified by the Senate, the Surgeon General, carrying the rank of vice-admiral, serves a four-year term leading a team of nearly 7,000 commissioned officers in the U.S. Public Health Service Commissioned Corps. Wearing the uniform of the U.S. Navy or the U.S. Coast Guard in homage to their beginnings, these elite health-care professionals achieve their mission by responding to immediate public health needs and advancing medical science. Additionally, the Surgeon General’s staff assists in emergencies as they did during the Ebola outbreak, Hurricane Katrina and the Deepwater Horizon oil spill.

President Ulysses S. Grant appointed the first Surgeon General, John Woodworth. Woodworth came to Grant’s attention as he rode alongside General Sherman on the March to the Sea. Woodworth took charge of the Ambulance Corps, staffed by soldiers either mentally or physically unfit for battle and so tasked with the care of the sick and injured.  Unfortunately, their medical skills were no better than their fighting skills and they were known for finding comfort in the “medicinal liquor”. Most men under their care did not fare well. The fate of the soldiers changed during Woodworth’s leadership, with the ambulance train carrying the infirm, making the 300-mile journey to Savannah with minimal loss of life, a rare feat which brought him to Grant’s attention. After his appointment as Surgeon General, Woodworth focused on the two health scourges of the day – yellow fever and cholera.

The Surgeon General has often served in anonymity, but a few have taken controversial stands on major health issues, attracting the attention of both the public and political leaders. While Terry’s report on tobacco caused a major shift in health care policies, the role of Surgeon General was still unknown to most Americans.  C. Everett Koop changed that.

In the early eighties, a new disease, AIDS, had come to America. Many Americans feared that even casual contact – shaking hands, using the same restroom, sharing food – could transmit the AIDS virus. In 1986, Surgeon General C. Everett Koop, appointed by President Ronald Reagan, authored a controversial report, stressing AIDS education based on scientific principles, rather than on moralistic judgments.  Koop also continued Terry’s campaign against smoking, accusing the tobacco industry of marketing to children and of covering up evidence of smoking’s link to cancer. His report on smoking was one of the first to cite the dangers of secondhand smoke. Blocked by some political leaders from spreading his message, Koop began traveling the country in his gold-braided, midnight-blue uniform, sounding the alarm about smoking and stressing the need for AIDS education.

The Surgeon General’s post is awaiting an appointment by the current administration, however, the previous Surgeon General was Vivek Murthy, the first Indian-American to hold that post. Nominated by President Barack Obama, Murthy’s Senate approval was stymied by a 2012 tweet blasting, “Tired of politicians playing politics w/guns, putting lives at risk.  Guns are a health care issue.” In response, the NRA launched a full-blown campaign against him. His nomination would probably have never been ratified, except that Ebola crossed America’s borders generating a deep public awareness of the need to have a knowledgeable medical professional giving guidance to the administration. With doctors in white lab-coats filling the Senate gallery to lend their support, Murthy was sanctioned by a vote of 51-43.

The U.S. Surgeon General is expected to be the ultimate conveyer of medical truths, unhampered by partisan politics. C. Everett Koop spoke out about AIDS even as Reagan administration officials asked him not to for fear of offending conservative values. Luther Terry admonished Americans about the dangers of smoking, even as tobacco companies labeled him a hypocrite for having smoked himself. As the 17th Surgeon General Richard Carmona noted, “You don’t want Republican or Democratic scientific information. You want real scientific information.” As the United States struggles with its current health concerns, such as Zika and the Flint water crisis, this admonishment should not go unheeded. America’s top doctor must be left unfettered to advise Americans on health care based on scientific facts  – whether they want to hear it or not.